Frustration with APAP, keep taking off mask at night!

[cycloman2005]

I've been avg. 3-4 hrs on my APAP, during the last couple of months. My monthly avg pressure is 8-9cm and AI is 0.5, AHI - 4.4, leak rate - 0.28l/s - EPR 3
I also have GERD which is being treated by omeprazole and domperidone. My bed is elevated. I get frustrated during the night with my Quattro mask and cannot tolerate the pressure. I tried lowering the EPR to 2 and 1 and to OFF. I have not been able to get the 7-8 hrs on the APAP that I used to get when I first started with my APAP. Could the GERD be contributing to my lower compliance hours on my APAP? Does the EPR really help with GERD symptoms? Should I turn EPR off? I find that the EPR helps my GERD symptoms and have less bloating. My original sleep study says that my titration is 16cm for CPAP, I had 55 events/hr which is considered severe sleep apnea. I get lower numbers when I sleep on my side, about 8cm and 12 cm when I sleep on my back with the APAP. My min pressure is 7cm and max pressure is 18cm. I also understand that an EPR setting of 3 would bring a min of 4cm and a max of 15cm. I wonder is this could be contributing to feeling suffocated and not being to tolerate the APAP pressures? I tried to CPAP mode on my Autoset II, I find the pressures hard to tolerate. I think that GERD might be the issue, I was diagnosed last year, GERD and OSA are often reported for those who have sleep apnea. The Quattro mask hurts the bridge of my nose! It seems to be worse as the mask gets older, I will get a new mask this month. What would be a good replacement FFM that would not hurt the bridge of my nose?
Any suggestions would be appreciated!
Thanks!

[Stormynights]

My husband started pulling his mask off in his sleep. I would wake him up to put it back on. He didn't like that at all. One night we were watching TV and an old lady had a stun gun. I told him I was thinking about getting one. He said why so you can use it on me when I pull my mask off? Well he hasn't pulled it off sense. I know this is not going to help you with your problem but it will bump it up back toward the top. I am hopeful you will get an answer.

[cycloman2005]

Thanks for your comments stormynights, I turned off EPR and will use straight pressure with no EPR tonight to see if it makes any difference.
I know I will get some input and possible solutions to my APAP issues.

[Stormynights]

I was going to put tape on his head gear to tape it to his face so he wouldn't pull it off but he so far has stopped.

[mgrunk]

I rip mine off in my sleep nearly every night - when I look at the data, I can see the leak rate go up, and the AHI, and the pressure - but I can't tell what comes first - is the mask leaking more because I'm having an apnea that the machine is trying to fix? I empathize, I've not had more than 3 or so hours in a row since June.

[Popi]

I had the same problem...but it only lasted for about two weeks, and I only removed my mask (Swift LT nasal pillow) about three times a week. Now, I don't even feel the mask. Keep with it, it does get better...if you're wearing the right mask/pillow and, if need be, the right chin strap/tape.

[cycloman2005]

popi,
I seem to think that it could be my Quattro mask, it's quite uncomfortable on some nights, it hurts the bridge of my nose! I've had the mask for about 6 months. The pillows could be wearing out. Used to wear a L size but now I switched to M it gets a better seal than the L size. Used APAP for about 4 hrs last night!
My numbers for last night:
Pressure - 7.4 cm - EPR 2
Leak - 0.44 l/s
AHI - 3.9
AI - 0.9
HI - 3.0
I think it's about time to order a new FFM to see if there is an improvement!

[Muse-Inc]

...My numbers for last night...Leak - 0.44 l/s...

Do you have your mask properly defined in the APAP? If so, that's too much leak. Until you get the leak under control, the numbers are unreliable. My Hybrid FFM vents more than any of ResMed's masks, so I use "MIR FULL" as the setting and expect a little leak on 'good seal' nights.

[cycloman2005]

Hi Muse,
I do have my setting set to MIR FULL on my Autoset II, I also ordered a new Resmed Quattro FFM today, I think my cushion is worn is not sealing properly. I have oily skin, and have to change my FFM every 6 months or so. I just wish the Quattro did not hurt the bridge of my nose so much! I have tried the Mirage Liberty Hybrid mask but I felt so congested using it! I guess you seem to like the Hybrid FFM, I heard that it is a very good FFM!

[FoxNewsFan]

Hi Muse,
I do have my setting set to MIR FULL on my Autoset II, I also ordered a new Resmed Quattro FFM today, I think my cushion is worn is not sealing properly. I have oily skin, and have to change my FFM every 6 months or so. I just wish the Quattro did not hurt the bridge of my nose so much! I have tried the Mirage Liberty Hybrid mask but I felt so congested using it! I guess you seem to like the Hybrid FFM, I heard that it is a very good FFM!

I may be wrong but the way you are phrasing it, it doesn't seem like you know that you can just order new cushions and not the whole mask. I change cushions every 2-3 months.

Have you tried the adjustment knob to take some pressure off your nose?

I have had very good luck with Pad A Cheek's anti-leak strap. It has reduced my leakage and therefore cut my apneas way down. It may reduce the pressure on your nose.

Last point- I have a pretty big head. I was using a medium size Quattro FFM until one day my online DME sent me a small by mistake. It turned out the small fit better than the medium. Experiment with different sizes.

Ed

[Muse-Inc]

...I have oily skin...

I have to have very clean skin and clean silicon to get a good seal; others report different results.

...I have tried the Mirage Liberty Hybrid mask...

Me too but my issue is that I couldn't stop the leaks, it just doesn't fit my facial anatomy.

...guess you seem to like the Hybrid FFM...

Yup, works well for me...of course, with my severe claustrophobia and fear of suffocation, a nose or traditional FFM is absolutely out of the question, so there's few choices

[cycloman2005]

hi foxnewsfan,
I know that the cushion on the Quattro can be replaced, my disability benefits allow me to get a new CPAP mask every 6 months. I do adjust the adjustment knob to take the pressure off my nose. It seems for me a psychological issue or when I feel tired, I get irritated and hard to tolerate the CPAP equipment. I had a better night last night, it did not feel like taking the mask off! I read on another post on this board that the S8 Autoset II does not clear the apneas very well compared to the S9. The S8 increases the CPAP pressure, that could be the reason why I feel that there is too much pressure, and thus I take my mask off!
I'm not due for a new machine in 3-4 years, then I would upgrade to the S9.

[cycloman2005]

An update! I have switched my Medium Quattro mask to Large, I found my old Large Quattro mask an tried to see if it would make a difference! To my surprise the bridge of my nose did not hurt as much and I slept for 6 hrs without taking off the mask! I will switch my Medium Quattro to a Large with my DME tomorrow. I guess I was experiencing mask discomfort! That made me more uncomfortable and felt frustrated! Mask size selection and fit is very important, that was the factor when I switched to the Medium to the Large Quattro, because of my prominent nose! lol

[ozij]

An update! I have switched my Medium Quattro mask to Large, I found my old Large Quattro mask an tried to see if it would make a difference! To my surprise the bridge of my nose did not hurt as much and I slept for 6 hrs without taking off the mask! I will switch my Medium Quattro to a Large with my DME tomorrow. I guess I was experiencing mask discomfort! That made me more uncomfortable and felt frustrated! Mask size selection and fit is very important, that was the factor when I switched to the Medium to the Large Quattro, because of my prominent nose! lol

Thanks for the update, Cycloman! That's the type of post that could by a great help to someone along the way. And congratulations.

[Mary T]

Maybe you don't like the feel of the current mask on your face. Maybe you could try one with minimal mask on your face, like a "hybrid" type. Believe me, when I compared the feel of one vs the other type, it made a huge difference. Some of the masks I hear can make a person feel claustrophobic. Or, it could be that you are not getting enough air, and you are pulling it off instinctively because you are having a hard time breathing. If your machine has the little computer chip that you send in to the company to get a read-out of your sleeping experience, that may indicate what is the matter, because when you are sleeping, you cannot tell how you are doing.